Organization · Type 2 NPI

Lewis and Clark Community College

Dentist · Godfrey, IL

NPI number 1497746077 Active

Practice location

5800 Godfrey Rd
Godfrey, IL 62035-2466

Fax (618) 468-4408

Specialties and licenses

Taxonomy	Code	License
Dentist Primary	122300000X	None listed

Dentist: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requiremen…

6 other providers at this address

NPI record

NPI: 1497746077
Entity type: Organization (Type 2)
Issued: Nov 2, 2005
Last updated: Aug 22, 2020
Status: Active

Other names

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Lewis and Clark Community College Dental Hygiene Clinic · doing business as

Authorized official

Dr. John Randall Miller, DDS
Clinic Supervisor
(618) 468-4414

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1497746077

Lewis and Clark Community College's National Provider Identifier is 1497746077, issued on Nov 2, 2005. The primary taxonomy on file is Dentist (122300000X), and the practice location is in Godfrey, IL. The record was last updated on Aug 22, 2020.